Pancreas transplantation indications clinical management and outcomes

Abstract

Although many advances have been made, pancreas transplantation still poses several challenges to the surgeon, internist and patient. With success rates now above 80% and improving yearly, diabetic patients must make a major life-style decision when considering a pancreas transplant. The main concerns are will the benefits of insulin-independence off-set the risks of surgery and immunosuppression. For diabetics near dialysis and considering a kidney transplant, the decision may not be as difficult. However, for those patients who are failing insulin therapy (brittle control) and remain with good renal function, the options are limited. As the success of pancreas transplantation improves, the procedure may become routine at more centers and become accepted by more third-party carriers. However, as with other solid organs, the availability of pancreases is limited and the supply soon to be exhausted. Thus, further advances are required for the prevention and treatment of Type 1 diabetes. Hopefully, the new frontiers of the next century will allow physicians to identify and preventively treat those at risk for the development of diabetes. Thus, the population of patients suffering from the consequences of this dreadful disease will be greatly reduced. With new developments in immunosuppression and islet transplantation, diabetic patients of the future may be offered the option of a procedure with reduced risks, less morbidity, and improved long-term cure rates.

TRIM21–SERPINB5 aids GMPS repression to protect nasopharyngeal carcinoma cells from radiation-induced apoptosis

“…TP53-governed apoptosis is considered the main cause of ionizing radiation-induced cell death, despite the fact that some cancer cells undergo TP53-independent apoptosis [6,7]. Therefore, the radioresistant tumor cells are often accompanied by TP53 mutation or repression, high levels of B-Cell CLL/ Lymphoma 2 (BCL2), or inhibition of the other apoptosis-related genes [8][9][10][11][12]. In NPC, it has been suggested that latent membrane protein 1 (LMP1), encoded by Epstein-Barr virus, blocks apoptosis and thereby facilitates radioresistance of the tumor cells [13].…”

TRIM21–SERPINB5 aids GMPS repression to protect nasopharyngeal carcinoma cells from radiation-induced apoptosis

“…TP53-governed apoptosis is considered the main cause of ionizing radiation-induced cell death, despite the fact that some cancer cells undergo TP53-independent apoptosis (Afshar, Jelluma et al, 2006, Strasberg Rieber, Zangemeister-Wittke et al, 2001. Therefore, the radioresistant tumor cells are often accompanied by TP53 mutation or repression, high levels of BCL2, or inhibition of the other apoptosis-related genes (Brown & Wouters, 1999, Leone, Humar et al, 1997, McGill & Fisher, 1997, Reed, Miyashita et al, 1996, Yaes, 1989. In NPC, it has been suggested that latent membrane protein 1 (LMP1), encoded by Epstein-Barr virus, blocks apoptosis and thereby facilitates radioresistance of the tumor cells (Lu, Ma et al, 2008).…”